HER-2 overexpression is a negative predictive factor for recurrence in patients with non-muscle-invasive bladder cancer on intravesical therapy

Abstract

Objective: HER-2 is overexpressed in a variety of human malignant tumors and has been widely used in the prognosis and treatment of breast cancer. In urothelial cell carcinoma of the bladder, some reports have shown an association between HER-2 overexpression and worse outcomes. The aim of this study was to examine the association between HER-2 expression and other clinicopathologic parameters in 48 patients treated for primary non-muscle-invasive transitional cell carcinoma of the bladder. Methods: The initial expression of HER-2 in tumor specimens and its expression upon disease recurrence following instillation therapy (BCG, Mitomycin, or Epirubicin) were studied. Results: HER-2 expression was significantly increased between these two timepoints. In multivariate analysis, HER-2 expression at the time of diagnosis was found to be the only independent factor and was associated with reduced recurrence free survival. Conclusions: HER-2 status could be an additional biomarker for predicting the outcome of nonmuscle-invasive bladder cancer, which could help identify high-risk patients for recurrence and possible progression who require close observation and perhaps radical treatment, such as early cystectomy.

The Clinical Significance and Prognostic Value of HER2 Expression in Bladder Cancer: A Meta-Analysis and a Bioinformatic Analysis

“…HER2 expression was also associated with large tumor size(>3cm) (OR=0.40; 95% CI:0.26–0.63; p<0.01) ( 14 , 17 , 20 , 23 , 27 ) ( Figure 2D ). In the HER2 positive tumors, the proportion of Ta stage was significantly lower than that in the negative tumors (OR=2.52;95%CI:1,58–4.01; p<0.01) ( 14 , 21 , 24 , 25 , 27 ) ( Figure 3A ). Furthermore, HER2 expression was linked with high tumor grade (OR=0.23; 95% CI:0.15–0.35; p<0.01) ( 14 – 18 , 20 , 23 – 27 ) ( Figure 3B ) and lymph node metastasis (OR=0.52; 95% CI:0.38–0.71; p<0.01) ( 15 , 16 , 21 , 25 , 26 ) ( Figure 3C ).…”

The prognostic value of E-cadherin and Ki-67 compared to standard histopathologic examination in non–muscle invasive bladder cancer

“…Recurrence has been connected to focality, multiplicity, past recurrences and general compliance of patients (20). A study on HER-2 expression in association to bladder cancer recurrence has shown signifi cantly increased expression level between the timepoint of initial diagnosis and recurrence, where the overexpression of HER-2 was associated with higher recurrence rates and could serve as predictive biomarker for NMIBC (21).…”

The Clinical Significance and Prognostic Value of HER2 Expression in Bladder Cancer: a Systematic Review and Meta-analysis

“…2d). In the HER2 positive tumors, the proportion of Ta stage was signi cantly lower than that in the negative tumors (OR = 2.52;95%CI:1,58-4.01; p < 0.01) [16,18,19,22,29] (Fig. 3a).…”

“…The results were as follows: recurrence (HR = 0.77; 95% CI:0.61-0.97; p = 0.02) [16, 20-22, 25, 26, 29] (Fig. 4d); 2-year recurrence-free survival (RFS) (HR = 1.22;95%CI:0.87-1.71; p = 0.25) [16,19] (Fig. 4e).…”

“…4b) than those with low expression of HER2. HER2 expression was associated with a low 2-year recurrence-free survival (RFS) rate (HR = 1.31; 95% CI:1.01-1.70; p = 0.04) [16][17][18][19] (Fig. 4c).…”